Scilight Press

Author Information

Received: 31 Dec 2025 | Revised: 24 Mar 2026 | Accepted: 09 Apr 2026 | Published: 20 Apr 2026

Abstract

Keywords

Manuka honey | methylglyoxal | antibacterial | antifungal | ESKAPE | antibiotic adjuvant

References 

• 1.

  Alvarez-Suarez, J.M.; Gasparrini, M.; Forbes-Hernández, T.Y.; et al. The composition and biological activity of honey: A focus on Manuka honey. Foods 2014, 3, 420–432. https://doi.org/10.3390/foods3030420.

• 2.

  Maddocks, S.E.; Jenkins, R.E. Honey: A sweet solution to the growing problem of antimicrobial resistance? Future Microbiol. 2013, 8, 1419–1429. https://doi.org/10.2217/fmb.13.105.

• 3.

  Lu, J.; Carter, D.A.; Turnbull, L.; et al. The effect of New Zealand kanuka, manuka and clover honeys on bacterial growth dynamics and cellular morphology varies according to the species. PLoS ONE 2013, 8, e55898. https://doi.org/10.1371/journal.pone.0055898.

• 4.

  Cooper, R. Honey for wound care in the 21st century. J. Wound Care 2016, 25, 544–552. https://doi.org/10.12968/jowc.2016.25.9.544.

• 5.

  Bouzo, D.; Cokcetin, N.N.; Li, L.; et al. Characterizing the mechanism of action of an ancient antimicrobial, Manuka honey, against Pseudomonas aeruginosa using modern transcriptomics. mSystems 2020, 5, e00106 20. https://doi.org/10.1128/mSystems.00106-20.

• 6.

  Adams, C.J.; Boult, C.H.; Deadman, B.J.; et al. Isolation by HPLC and characterisation of the bioactive fraction of New Zealand manuka (Leptospermum scoparium) honey. Carbohydr. Res. 2008, 343, 651–659. https://doi.org/10.1016/j.carres.2007.12.011.

• 7.

  Meda, A.; Lamien, C.E.; Romito, M.; et al. Determination of the total phenolic, flavonoid and proline contents in Burkina Fasan honey, as well as their radical scavenging activity. Food Chem. 2005, 91, 571–577. https://doi.org/10.1016/j.foodchem.2004.10.006.

• 8.

  Mulani, M.S.; Kamble, E.E.; Kumkar, S.N.; et al. Emerging strategies to combat ESKAPE pathogens in the era of antimicrobial resistance: A review. Front. Microbiol. 2019, 10, 539. https://doi.org/10.3389/fmicb.2019.00539.

• 9.

  Miller, W.R.; Arias, C.A. ESKAPE pathogens: Antimicrobial resistance, epidemiology, clinical impact and therapeutics. Nat. Rev. Microbiol. 2024, 22, 598–616. https://doi.org/10.1038/s41579-024-01054-w.

• 10.

  Santajit, S.; Indrawattana, N. Mechanisms of antimicrobial resistance in ESKAPE pathogens. BioMed Res. Int. 2016, 2016, 2475067. https://doi.org/10.1155/2016/2475067.

• 11.

  Olaniyan, T.O.; Martínez-Vázquez, A.V.; Escobedo-Bonilla, C.M.; et al. The prevalence of ESKAPE pathogens and their drug resistance profiles in aquatic environments around the world. Microbiol. Res. 2025, 16, 201. https://doi.org/10.3390/microbiolres16090201.

• 12.

  Almasaudi, S.B. The antibacterial activities of honey. Saudi J. Biol. Sci. 2021, 28, 2188–2196. https://doi.org/10.1016/j.sjbs.2020.10.017.

• 13.

  Majtan, J.; Bohova, J.; Prochazka, E.; Klaudiny, J. Methylglyoxal may affect hydrogen peroxide accumulation in Manuka honey through the inhibition of glucose oxidase. J. Med. Food 2014, 17, 290–293. https://doi.org/10.1089/jmf.2012.0201.

• 14.

  Majtan, J.; Bohova, J.; Horniackova, M.; et al. Anti biofilm effects of honey against wound pathogens Proteus mirabilis and Enterobacter cloacae. Phytother. Res. 2014, 28, 69–75. https://doi.org/10.1002/ptr.4957.

• 15.

  Thierig, M.; Raupbach, J.; Wolf, D.; et al. 3 Phenyllactic acid and polyphenols are substances enhancing the antibacterial effect of methylglyoxal in Manuka honey. Foods 2023, 12, 1098. https://doi.org/10.3390/foods12051098.

• 16.

  Qu, Q.; Cui, W.; Huang, X.; et al. Gallic acid restores the sulfonamide sensitivity of multidrug resistant Streptococcus suis via polypharmacology mechanism. J. Agric. Food Chem. 2023, 71, 6894–6907. https://doi.org/10.1021/acs.jafc.2c06991.

• 17.

  Henriques, A.F.; Jenkins, R.E.; Burton, N.F.; et al. The intracellular effects of Manuka honey on Staphylococcus aureus. Eur. J. Clin. Microbiol. Infect. Dis. 2010, 29, 45–50. https://doi.org/10.1007/s10096-009-0817-2.

• 18.

  Jenkins, R.; Burton, N.; Cooper, R. Manuka honey inhibits cell division in methicillin resistant Staphylococcus aureus. J. Antimicrob. Chemother. 2011, 66, 2536–2542. https://doi.org/10.1093/jac/dkr340.

• 19.

  Cooper, R.A.; Jenkins, L.; Henriques, A.F.M.; et al. Absence of bacterial resistance to medical grade Manuka honey. Eur. J. Clin. Microbiol. Infect. Dis. 2010, 29, 1237–1241. https://doi.org/10.1007/s10096-010-0992-1.

• 20.

  Lu, J.; Turnbull, L.; Burke, C.M.; et al. Manuka type honeys can eradicate biofilms produced by Staphylococcus aureus strains with different biofilm forming abilities. PeerJ 2014, 2, e326. https://doi.org/10.7717/peerj.326.

• 21.

  Kot, B.; Sytykiewicz, H.; Sprawka, I.; et al. Effect of Manuka honey on biofilm associated gene expression during methicillin resistant Staphylococcus aureus biofilm formation. Sci. Rep. 2020, 10, 13552. https://doi.org/10.1038/s41598-020-70666-y.

• 22.

  Camplin, A.L.; Maddocks, S.E. Manuka honey treatment of biofilms of Pseudomonas aeruginosa results in the emergence of isolates with increased honey resistance. Ann. Clin. Microbiol. Antimicrob. 2014, 13, 19. https://doi.org/10.1186/1476-0711-13-19.

• 23.

  Johnston, M.; McBride, M.; Dahiya, D.; et al. Antibacterial activity of Manuka honey and its components: An overview. AIMS Microbiol. 2018, 4, 655–664. https://doi.org/10.3934/microbiol.2018.4.655.

• 24.

  Cooper, R.A.; Molan, P.C.; Harding, K.G. The sensitivity to honey of gram positive cocci of clinical significance isolated from wounds. J. Appl. Microbiol. 2002, 93, 857–863. https://doi.org/10.1046/j.1365-2672.2002.01761.x.

• 25.

  George, N.M.; Cutting, K.F. Antibacterial Honey (MedihoneyTM): In-vitro Activity Against Clinical Isolates of MRSA, VRE, and Other Multiresistant Gram-negative Organisms Including Pseudomonas aeruginosa. Wounds 2007, 19, 231–236.

• 26.

  Hussain, M.B.; Hannan, A.; Absar, M.; et al. In vitro susceptibility of methicillin resistant Staphylococcus aureus to honey. Complement. Ther. Clin. Pract. 2017, 27, 57–60. https://doi.org/10.1016/j.ctcp.2017.04.003.

• 27.

  Brudzynski, K.; Lannigan, R. Mechanism of honey bacteriostatic action against MRSA and VRE involves hydroxyl radicals generated from honey’s hydrogen peroxide. Front. Microbiol. 2012, 3, 36. https://doi.org/10.3389/fmicb.2012.00036.

• 28.

  Packer, J.M.; Irish, J.; Herbert, B.R.; et al. Specific non peroxide antibacterial effect of Manuka honey on the Staphylococcus aureus proteome. Int. J. Antimicrob. Agents 2012, 40, 43–50. https://doi.org/10.1016/j.ijantimicag.2012.03.012.

• 29.

  Jenkins, R.; Burton, N.; Cooper, R. Proteomic and genomic analysis of methicillin resistant Staphylococcus aureus exposed to Manuka honey in vitro demonstrated down regulation of virulence markers. J. Antimicrob. Chemother. 2014, 69, 603–615. https://doi.org/10.1093/jac/dkt430.

• 30.

  Jenkins, R.; Burton, N.; Cooper, R. Effect of Manuka honey on the expression of universal stress protein A in methicillin resistant Staphylococcus aureus. Int. J. Antimicrob. Agents 2011, 37, 373–376. https://doi.org/10.1016/j.ijantimicag.2010.11.036.

• 31.

  Liu, M.Y.; Cokcetin, N.N.; Lu, J.; et al. Rifampicin–Manuka honey combinations are superior to other antibiotic–Manuka honey combinations in eradicating Staphylococcus aureus biofilms. Front. Microbiol. 2018, 8, 2653. https://doi.org/10.3389/fmicb.2017.02653.

• 32.

  Müller, P.; Alber, D.G.; Turnbull, L.; et al. Synergism between Medihoney and rifampicin against methicillin resistant Staphylococcus aureus (MRSA). PLoS ONE 2013, 8, e57679. https://doi.org/10.1371/journal.pone.0057679.

• 33.

  Jenkins, R.E.; Cooper, R. Synergy between oxacillin and Manuka honey sensitizes methicillin resistant Staphylococcus aureus to oxacillin. J. Antimicrob. Chemother. 2012, 67, 1405–1407. https://doi.org/10.1093/jac/dks071.

• 34.

  Hayes, G.; Wright, N.; Gardner, S.L.; et al. Manuka honey and methylglyoxal increase the sensitivity of Staphylococcus aureus to linezolid. Lett. Appl. Microbiol. 2018, 66, 491–495. https://doi.org/10.1111/lam.12880.

• 35.

  Girma, A.; Seo, W.; She, R.C. Antibacterial activity of varying UMF graded Manuka honeys. PLoS ONE 2019, 14, e0224495. https://doi.org/10.1371/journal.pone.0224495.

• 36.

  Henriques, A.F.; Jenkins, R.E.; Burton, N.F.; et al. The effect of Manuka honey on the structure of Pseudomonas aeruginosa. Eur. J. Clin. Microbiol. Infect. Dis. 2011, 30, 167–171. https://doi.org/10.1007/s10096-010-1065-1.

• 37.

  Roberts, A.E.L.; Maddocks, S.E.; Cooper, R.A. Manuka honey is bactericidal against Pseudomonas aeruginosa and results in differential expression of oprF and algD. Microbiology 2012, 158, 3005–3013. https://doi.org/10.1099/mic.0.062794-0.

• 38.

  Roberts, A.E.L.; Maddocks, S.E.; Cooper, R.A. Manuka honey reduces the motility of Pseudomonas aeruginosa by suppression of flagella associated genes. J. Antimicrob. Chemother. 2015, 70, 716–725. https://doi.org/10.1093/jac/dku448.

• 39.

  Kronda, J.M.; Cooper, R.A.; Maddocks, S.E. Manuka honey inhibits siderophore production in Pseudomonas aeruginosa. J. Appl. Microbiol. 2013, 115, 86–90. https://doi.org/10.1111/jam.12222.

• 40.

  Prateeksha, S.B.; Shoeb, M.; Sharma, S.; et al. Scaffold of selenium nanovectors and honey phytochemicals for inhibition of Pseudomonas aeruginosa quorum sensing and biofilm formation. Front. Cell. Infect. Microbiol. 2017, 7, 93. https://doi.org/10.3389/fcimb.2017.00093.

• 41.

  Lu, J.; Cokcetin, N.N.; Burke, C.M.; et al. Honey can inhibit and eliminate biofilms produced by Pseudomonas aeruginosa. Sci. Rep. 2019, 9, 18160. https://doi.org/10.1038/s41598-019-54576-2.

• 42.

  Cooper, R.; Jenkins, L.; Hooper, S. Inhibition of biofilms of Pseudomonas aeruginosa by Medihoney in vitro. J. Wound Care 2014, 23, 93–104. https://doi.org/10.12968/jowc.2014.23.3.93.

• 43.

  Nolan, V.C.; Harrison, J.; Cox, J.A.G. Dissecting the antimicrobial composition of honey. Antibiotics 2019, 8, 251. https://doi.org/10.3390/antibiotics8040251.

• 44.

  Ali, S.; Sagheer, A.; Nazneen, H.; et al. Manuka honey as a potential treatment for mcr 1 harboring E. coli and Klebsiella isolates from urinary tract infections. Pak Euro J. Med. Life Sci. 2025, 8, 639–646.

• 45.

  Qamar, M.U.; Saleem, S.; Toleman, M.A.; et al. In vitro and in vivo activity of Manuka honey against NDM 1 producing Klebsiella pneumoniae ST11. Future Microbiol. 2018, 13, 13–26. https://doi.org/10.2217/fmb-2017-0119.

• 46.

  Shah, P.J.; Williamson, M.T. Antibacterial activity of honey against ESBL producing Klebsiella pneumoniae from burn wound infections. Int. J. Curr. Pharm. Res. 2015, 7, 32–36.

• 47.

  El Meidany, W.M.A.; El Mamlouk, E.A.; El Kholy, M.A.; et al. Exploring the in vitro activity of the combination of Manuka honey and Cinnamomum verum bark oil against carbapenem resistant Acinetobacter baumannii clinical isolates. Microbes Infect. Dis. 2025, 6, 6677–6688. https://doi.org/10.21608/mid.2025.364249.2580.

• 48.

  Hewett, S.R.; Crabtrey, S.D.; Dodson, E.E.; et al. Both Manuka and non Manuka honey types inhibit antibiotic resistant wound infecting bacteria. Antibiotics 2022, 11, 1132. https://doi.org/10.3390/antibiotics11081132.

• 49.

  Combarros Fuertes, P.; Estevinho, L.M.; Teixeira Santos, R.; et al. Antibacterial action mechanisms of honey: Physiological effects of avocado, chestnut, and polyfloral honey upon Staphylococcus aureus and Escherichia coli. Molecules 2020, 25, 1252. https://doi.org/10.3390/molecules25051252.

• 50.

  Oinaala, D.; Lehesvaara, M.; Lyhs, U.; et al. Antimicrobial activity of organic honeys against food pathogenic bacterium Clostridium perfringens. Org. Agric. 2015, 5, 153–159. https://doi.org/10.1007/s13165-015-0103-9.

• 51.

  Banaeian Borujeni, S.; Mobini, G.R.; Pourgheysari, B.; et al. Comparison of the effect of honey and miconazole against Candida albicans in vitro. Adv. Biomed. Res. 2013, 2, 57. https://doi.org/10.4103/2277-9175.115800.

• 52.

  de Groot, T.; Janssen, T.; Faro, D.; et al. Antifungal activity of a medical grade honey formulation against Candida auris. J. Fungi 2021, 7, 50. https://doi.org/10.3390/jof7010050.

• 53.

  Du, W.; Wang, Q.; Zhao, M. Innovative antifungal strategies to combat drug resistant Candida auris: Recent advances and clinical implications. Front. Cell. Infect. Microbiol. 2025, 15, 1641373. https://doi.org/10.3389/fcimb.2025.1641373.

• 54.

  Haines, R.R.; Xi, S.; Green, K.J.; et al. In vitro activity of Western Australian honeys and Manuka honey against clinically important yeasts. Yeast 2024, 41, 537–548. https://doi.org/10.1002/yea.3974.

• 55.

  Fernandes, L.; Oliveira, A.; Henriques, M.; et al. Honey as a strategy to fight Candida tropicalis in mixed biofilms with Pseudomonas aeruginosa. Antibiotics 2020, 9, 43. https://doi.org/10.3390/antibiotics9020043.

• 56.

  Hermanns, R.; Cremers, N.A.J.; Leeming, J.P.; et al. Sweet relief: Determining the antimicrobial activity of medical grade honey against vaginal isolates of Candida albicans. J. Fungi 2019, 5, 85. https://doi.org/10.3390/jof5030085.

• 57.

  Yabes, J.M.; White, B.K.; Murray, C.K.; et al. In vitro activity of Manuka honey and polyhexamethylene biguanide on filamentous fungi and toxicity to human cell lines. Med. Mycol. 2017, 55, 334–343. https://doi.org/10.1093/mmy/myw070.

• 58.

  Jenkins, R.; Cooper, R. Improving antibiotic activity against wound pathogens with Manuka honey in vitro. PLoS ONE 2012, 7, e45600. https://doi.org/10.1371/journal.pone.0045600.

• 59.

  Campeau, M.E.M.; Patel, R. Antibiofilm activity of Manuka honey in combination with antibiotics. Int. J. Bacteriol. 2014, 2014, 795281. https://doi.org/10.1155/2014/795281.

• 60.

  DeCarolis, M.; Tessler, M.; DeCarolis, E.; et al. Synergism between Manuka honey and penicillin antibiotics against Escherichia coli. J. Food Sci. Nutr. Res. 2019, 2, 270–273.

• 61.

  Nolan, V.C.; Harrison, J.; Cox, J.A.G. Manuka honey in combination with azithromycin shows potential for improved activity against Mycobacterium abscessus. Cell Surf. 2022, 8, 100090. https://doi.org/10.1016/j.tcsw.2022.100090.

• 62.

  Johnson, D.W.; Van Eps, C.; Mudge, D.W.; et al. Randomized, controlled trial of topical exit site application of honey (Medihoney) versus mupirocin for the prevention of catheter associated infections in hemodialysis patients. J. Am. Soc. Nephrol. 2005, 16, 1456–1462. https://doi.org/10.1681/ASN.2004110997.

• 63.

  Merckoll, P.; Jonassen, T.Ø.; Vad, M.E.; et al. Bacteria, biofilm and honey: A study of the effects of honey on “planktonic” and biofilm embedded chronic wound bacteria. Scand. J. Infect. Dis. 2009, 41, 341–347. https://doi.org/10.1080/00365540902849383.

• 64.

  Krishnakumar, G.S.; Mahendiran, B.; Gopalakrishnan, S.; et al. Honey based treatment strategies for infected wounds and burns: A systematic review of recent pre clinical research. Wound Med. 2020, 30, 100188. https://doi.org/10.1016/j.wndm.2020.100188.

• 65.

  Sindi, M.V.; Chawn, M.E.; Hernandez, K.; et al. Anti biofilm effects and characterisation of the hydrogen peroxide activity of a range of Western Australian honeys compared to Manuka and multiflora honeys. Sci. Rep. 2019, 9, 17666. https://doi.org/10.1038/s41598-019-54217-8.

• 66.

  Natarajan, S.; Williamson, D.; Grey, J.; et al. Healing of an MRSA colonized, hydroxyurea induced leg ulcer with honey. J. Dermatol. Treat. 2001, 12, 33–36. https://doi.org/10.1080/095466301750163563.

• 67.

  Nair, H.K.R.; Tatavilis, N.; Pospíšilová, I.; et al. Medical grade honey kills antibiotic resistant bacteria and prevents amputation in diabetics with infected ulcers: A prospective case series. Antibiotics 2020, 9, 529. https://doi.org/10.3390/antibiotics9090529.

• 68.

  Mosteiro Miguéns, D.G.; Herrera Jiménez, C.; Lorenzo Ruiz, H.; et al. Successful treatment of a venous leg ulcer with MH: A case study. J. Wound Ostomy Cont. Nurs. 2021, 48, 79–82. https://doi.org/10.1097/WON.0000000000000712.

• 69.

  Kapoor, N.; Yadav, R. Manuka honey: A promising wound dressing material for chronic non healing discharging wounds: A retrospective study. Natl. J. Maxillofac. Surg. 2021, 12, 233–237. https://doi.org/10.4103/njms.njms_154_20.

• 70.

  Paunica Panea, G.; Teodorescu, S.; Preda, A.; et al. Chronic wound management: Surgical therapy and complementary nursing with Manuka honey. J. Mind Med. Sci. 2023, 10, 15. https://doi.org/10.22543/2392-7674.1387.

• 71.

  Gethin, G.; Cowman, S. Bacteriological changes in sloughy venous leg ulcers treated with Manuka honey or hydrogel: An RCT. J. Wound Care 2008, 17, 241–247. https://doi.org/10.12968/jowc.2008.17.6.29583.

• 72.

  Gill, R.; Poojar, B.; Bairy, L.K.; et al. Comparative evaluation of wound healing potential of Manuka and Acacia honey in diabetic and nondiabetic rats. J. Pharm. Bioallied Sci. 2019, 11, 116–126. https://doi.org/10.4103/JPBS.JPBS_257_18.

• 73.

  Frydman, G.H.; Olaleye, D.; Annamalai, D.; et al. Manuka honey microneedles for enhanced wound healing and the prevention and/or treatment of methicillin resistant Staphylococcus aureus (MRSA) surgical site infection. Sci. Rep. 2020, 10, 13229. https://doi.org/10.1038/s41598-020-70186-9.

• 74.

  Simon, A.; Traynor, K.; Santos, K.; et al. Medical honey for wound care—Still the ‘latest resort’? Evid. Based Complement. Altern. Med. 2009, 6, 165–173. https://doi.org/10.1093/ecam/nem175.

• 75.

  Weigelt, M.A.; McNamara, S.A.; Sanchez, D.; et al. Evidence based review of antibiofilm agents for wound care. Adv. Wound Care 2021, 10, 13–23. doi: 10.1089/wound.2020.1193.

• 76.

  Shaikh Kader, N.; Houreld, N.N.; Rajendran, K.; et al. The link between advanced glycation end products and apoptosis in delayed wound healing. Cell Biochem. Funct. 2019, 37, 432–442. https://doi.org/10.1002/cbf.3424.

• 77.

  Mavric, E.; Wittmann, S.; Barth, G.; et al. Identification and quantification of methylglyoxal as the dominant antibacterial constituent of Manuka (Leptospermum scoparium) honeys from New Zealand. Mol. Nutr. Food Res. 2008, 52, 483–489. https://doi.org/10.1002/mnfr.200700282.

• 78.

  Kwakman, P.H.S.; Van den Akker, J.P.C.; Güçlü, A.; et al. Medical grade honey kills antibiotic resistant bacteria in vitro and eradicates skin colonization. Clin. Infect. Dis. 2008, 46, 1677–1682. https://doi.org/10.1086/587892.

• 79.

  Carter, D.A.; Blair, S.E.; Cokcetin, N.N.; et al. Therapeutic Manuka honey: No longer so alternative. Front. Microbiol. 2016, 7, 569. https://doi.org/10.3389/fmicb.2016.00569.

• 80.

  Hossen, M.S.; Ali, M.Y.; Jahurul, M.H.A.; et al. Beneficial roles of honey polyphenols against some human degenerative diseases: A review. Pharmacol. Rep. 2017, 69, 1194–1205. https://doi.org/10.1016/j.pharep.2017.07.002.

• 81.

  Brudzynski, K.; Abubaker, K.; Miotto, D. Unraveling a mechanism of honey antibacterial action: Polyphenol/H2O2 induced oxidative effect on bacterial cell growth and DNA degradation. Food Chem. 2012, 133, 329–336. https://doi.org/10.1016/j.foodchem.2012.01.035.

• 82.

  Truchado, P.; López Gálvez, F.; Gil, M.I.; et al. Quorum sensing inhibitory and antimicrobial activities of honeys and the relationship with individual phenolics. Food Chem. 2009, 115, 1337–1344. https://doi.org/10.1016/j.foodchem.2009.01.065.

• 83.

  Sousa, J.M.; de Souza, E.L.; Marques, G.; et al. Polyphenolic profile and antioxidant and antibacterial activities of monofloral honeys produced by Meliponini in the Brazilian semiarid region. Food Res. Int. 2016, 84, 61–68. https://doi.org/10.1016/j.foodres.2016.03.012.

• 84.

  Karabagias, I.K.; Vavoura, M.V.; Nikolaou, C.; et al. Floral authentication of Greek unifloral honeys based on phenolic compounds, physicochemical parameters and chemometrics. Food Res. Int. 2014, 62, 753–760. https://doi.org/10.1016/j.foodres.2014.04.015.

• 85.

  Brudzynski, K. A current perspective on hydrogen peroxide production in honey: A review. Food Chem. 2020, 332, 127229. https://doi.org/10.1016/j.foodchem.2020.127229.

• 86.

  Brudzynski, K.; Abubaker, K.; St Martin, L.; et al. Re examining the role of hydrogen peroxide in bacteriostatic and bactericidal activities of honey. Front. Microbiol. 2011, 2, 213. https://doi.org/10.3389/fmicb.2011.00213.

• 87.

  Brudzynski, K.; Abubaker, K.; Wang, T. Powerful bacterial killing by buckwheat honeys is concentration dependent, involves complete DNA degradation and requires hydrogen peroxide. Front. Microbiol. 2012, 3, 242. https://doi.org/10.3389/fmicb.2012.00242.

• 88.

  Proaño, A.; Coello, D.; Villacrés Granda, I.; et al. The osmotic action of sugar combined with hydrogen peroxide and bee derived antibacterial peptide defensin 1 is crucial for the antibiofilm activity of eucalyptus honey. LWT 2021, 136, 110379. https://doi.org/10.1016/j.lwt.2020.110379.

• 89.

  Poli, J.P.; Guinoiseau, E.; Luciani, A.; et al. Key role of hydrogen peroxide in antimicrobial activity of spring, honeydew maquis and chestnut grove Corsican honeys on Pseudomonas aeruginosa DNA. Lett. Appl. Microbiol. 2018, 66, 427–433. https://doi.org/10.1111/lam.12868.

• 90.

  Fyfe, L.; Okoro, P.; Paterson, E.; et al. Compositional analysis of Scottish honeys with antimicrobial activity against antibiotic resistant bacteria reveals novel antimicrobial components. LWT—Food Sci. Technol. 2017, 79, 52–59. https://doi.org/10.1016/j.lwt.2017.01.023.

• 91.

  Bucekova, M.; Jardekova, L.; Juricova, V.; et al. Antibacterial activity of different blossom honeys: New findings. Molecules 2019, 24, 1573. https://doi.org/10.3390/molecules24081573.

• 92.

  Liu, J.R.; Ye, Y.L.; Lin, T.Y.; et al. Effect of floral sources on the antioxidant, antimicrobial, and anti inflammatory activities of honeys in Taiwan. Food Chem. 2013, 139, 938–943. https://doi.org/10.1016/j.foodchem.2013.02.015.

• 93.

  Karabagias, I.K.; Maia, M.; Karabagias, V.K.; et al. Quality and origin characterisation of Portuguese, Greek, Oceanian, and Asian honey based on poly parametric analysis with dimension reduction and classification techniques. Eur. Food Res. Technol. 2020, 246, 987–1006. https://doi.org/10.1007/s00217-020-03461-8.

• 94.

  Brudzynski, K.; Sjaarda, C. Antibacterial compounds of Canadian honeys target bacterial cell wall inducing phenotype changes, growth inhibition and cell lysis resembling β lactam antibiotics. PLoS ONE 2014, 9, e106967. https://doi.org/10.1371/journal.pone.0106967.

• 95.

  Wasfi, R.; Elkhatib, W.F.; Khairalla, A.S. Effects of selected Egyptian honeys on the cellular ultrastructure and gene expression profile of Escherichia coli. PLoS ONE 2016, 11, e0150984. https://doi.org/10.1371/journal.pone.0150984.

• 96.

  Anand, S.; Deighton, M.; Livanos, G.; et al. Antimicrobial activity of Agastache honey and characterization of its bioactive compounds in comparison with important commercial honeys. Front. Microbiol. 2019, 10, 263. https://doi.org/10.3389/fmicb.2019.00263.

• 97.

  Gobin, I.; Crnković, G.; Magdalenić, M.; et al. Antibacterial potential of Croatian honey against antibiotic resistant pathogenic bacteria. Med. Glas. 2018, 15, 139–144. https://doi.org/10.17392/951-18.

• 98.

  Al Kafaween, M.A.; Al Groom, R.M.; Hilmi, A.B.M. Comparison of the antimicrobial and antivirulence activities of Sidr and Tualang honeys with Manuka honey against Staphylococcus aureus. Iran. J. Microbiol. 2023, 15, 89–101. https://doi.org/10.18502/ijm.v15i1.11923.

• 99.

  Gosliński, M.; Nowak, D.; Kłębukowska, L. Antioxidant properties and antimicrobial activity of Manuka honey versus Polish honeys. J. Food Sci. Technol. 2020, 57, 1269–1277. https://doi.org/10.1007/s13197-019-04159-w.

• 100.

  Pentos, K.; Łuczycka, D.; Oszmianski, J.; et al. Polish honey as a source of antioxidants—A comparison with Manuka honey. J. Apic. Res. 2020, 59, 939–945. https://doi.org/10.1080/00218839.2020.1723837.

• 101.

  Roshan, N.; Rippers, T.; Locher, C.; et al. Antibacterial activity and chemical characteristics of several Western Australian honeys compared to Manuka honey and pasture honey. Arch. Microbiol. 2017, 199, 347–355. https://doi.org/10.1007/s00203-016-1308-3.

• 102.

  Ankley, L.M.; Monteiro, M.P.; Camp, K.M.; et al. Manuka honey chelates iron and impacts iron regulation in key bacterial pathogens. J. Appl. Microbiol. 2020, 128, 1015–1024. https://doi.org/10.1111/jam.14534.

• 103.

  Luong, A.D.; Moorthy, M.; Luong, J.H.T. Microbial biosurfactants: Antimicrobial agents against pathogens. Macromol. 2026, 6, 6. https://doi.org/10.3390/macromol6010006.

• 104.

  Luong, A.D.; Maruthapandi, M.; Gedanken, A.; et al. Rare earth oxide nanoparticles: A new weapon against multidrug resistant pathogens with potential wound healing treatment. Nanomaterials 2025, 15, 1862. https://doi.org/10.3390/nano15241862.

• 105.

  Lu, W. J.; Lin, H. J.; Hsu, P. H.; et al. Determination of drug efflux pump efficiency in drug resistant bacteria using MALDI TOF MS. Antibiotics 2020, 9, 639. https://doi.org/10.3390/antibiotics9100639.

• 106.

  Shen, A.Z.; Taha, M.; Ghannoum, M.; et al. Biofilms and chronic wounds: Pathogenesis and treatment options. J. Clin. Med. 2025, 14, 7784. https://doi.org/10.3390/jcm14217784.

• 107.

  Kalan, L.; Grice, E.A. Fungi in the wound microbiome. Adv. Wound Care 2018, 7, 247–255. https://doi.org/10.1089/wound.2017.0756.

• 108.

  Yu, L.; Palafox Rosas, R.; Luna, B.; et al. The bactericidal activity and spore inhibition effect of Manuka honey against Clostridioides difficile. Antibiotics 2020, 9, 684. https://doi.org/10.3390/antibiotics9100684.

• 109.

  Guo, K.; Yang, Z.; Yu, C. H.; et al. Artificial intelligence and machine learning in design of mechanical materials. Mater. Horiz. 2021, 8, 1153–1172.

• 110.

  Kumar, M.; Nguyen, T.P.N.; Kaur, J.; et al. Opportunities and challenges in application of artificial intelligence in pharmacology. Pharmacol. Rep. 2023, 75, 3–18.

• 111.

  Miyazawa, T.; Hiratsuka, Y.; Toda, M.; et al. Artificial intelligence in food science and nutrition: A narrative review. Nutr. Rev. 2022, 80, 2288–2300. https://doi.org/10.1093/nutrit/nuac033.

• 112.

  Kutyauripo, M.; Rushambwa, L.; Chiwazi, L. Artificial intelligence applications in the agrifood sectors. J. Agric. Food Res. 2023, 11, 100502.